Erythema Multiforme
Basics
Description
Description
- A rash caused by a hypersensitivity reaction:
- May occur in response to various medications, infections, or other illness
- Erythema multiforme (EM) minor:
- Typical target lesions
- Edematous papules
- Usually distributed peripherally
- Benign, self-limited rash generally not associated with acute, serious illness
- EM major:
- Target lesions
- Edematous papules
- Also with peripheral distribution
- Involves 1 or more mucous membranes
- <10% total body surface area of epidermal detachment
- Differentiate from:
- Stevens–Johnson syndrome (SJS):
- Also <10% TBSA epidermal detachment
- Often widespread blisters over trunk and face
- Mucosal involvement
- Toxic epidermal necrolysis (TEN):
- >30% TBSA epidermal detachment
- EM is distinct from SJS and TEN
- Stevens–Johnson syndrome (SJS):
- Most often affects children and young adults (>50% younger than 20 yr)
- Males are affected more often than females
Etiology
Etiology
- Hypersensitivity reaction, probably transient autoimmune defect
- Herpes simplex virus (HSV) is the most common precipitant (>70%)
- Other causes include:
- Infection:
- Mycoplasma
- HIV
- CMV
- Hepatitis C medications:
- Sulfa drugs
- Anticonvulsants
- Antibiotics
- Vaccines:
- Diphtheria–tetanus
- Hepatitis B
- Smallpox
- Malignancy
- Idiopathic
- Infection:
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Citation
Schaider, Jeffrey J., et al., editors. "Erythema Multiforme." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307319/all/Erythema_Multiforme.
Erythema Multiforme. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307319/all/Erythema_Multiforme. Accessed December 10, 2024.
Erythema Multiforme. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307319/all/Erythema_Multiforme
Erythema Multiforme [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 10]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307319/all/Erythema_Multiforme.
* Article titles in AMA citation format should be in sentence-case
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T1 - Erythema Multiforme
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ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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PB - Lippincott Williams & Wilkins
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